Nurse staffing and postsurgical adverse events

An analysis of administrative data from a sample of U.S. Hospitals, 1990-1996

Christine Kovner, Cheryl Jones, Chunliu Zhan, Peter J. Gergen, Jayasree Basu

Research output: Contribution to journalArticle

Abstract

Objective. To examine the impact of nurse staffing on selected adverse events hypothesized to be sensitive to nursing care between 1990 and 1996, after controlling for hospital characteristics. Data Sources/Study Setting. The yearly cross-sectional samples of hospital discharges for states participating in the National Inpatient Sample (NIS) from 1990-1996 were combined to form the analytic sample. Six states were included for 1990-1992, four states were added for the period 1993-1994, and three additional states were added in 1995-1996. Study Design. The study design was cross-sectional descriptive. Data Collection/Extraction Methods. Data for patients aged 18 years and older who were discharged between 1990 and 1996 were used to create hospital-level adverse event indicators. Hospital-level adverse event data were defined by quality indicators developed by the Health Care Utilization Project (HCUP). These data were matched to American Hospital Association (AHA) data on community hospital characteristics, including registered nurse (RN) and licensed practical/vocational nurse (LPN) staffing hours, to examine the relationship between nurse staffing and four postsurgical adverse events: venous thrombosis/pulmonary embolism, pulmonary compromise after surgery, urinary tract infection, and pneumonia. Multivariate modeling using Poisson regression techniques was used. Principal Findings. An inverse relationship was found between RN hours per adjusted inpatient day and pneumonia (p < .05) for routine and emergency patient admissions. Conclusions. The inverse relationship between pneumonia and nurse staffing are consistent with previous findings in the literature. The results provide additional evidence for health policy makers to consider when making decisions about required staffing levels to minimize adverse events.

Original languageEnglish (US)
Pages (from-to)611-629
Number of pages19
JournalHealth Services Research
Volume37
Issue number3
DOIs
StatePublished - Jun 2002

Fingerprint

staffing
nurse
Nurses
event
Pneumonia
Inpatients
American Hospital Association
Patient Acceptance of Health Care
State Hospitals
staffing level
Information Storage and Retrieval
Patient Admission
Community Hospital
Nursing Care
Health Policy
Administrative Personnel
Pulmonary Embolism
Urinary Tract Infections
Venous Thrombosis
Decision Making

Keywords

  • Adverse events
  • Outcomes
  • Registered nurse
  • Staffing

ASJC Scopus subject areas

  • Nursing(all)
  • Health(social science)
  • Health Professions(all)
  • Health Policy

Cite this

Nurse staffing and postsurgical adverse events : An analysis of administrative data from a sample of U.S. Hospitals, 1990-1996. / Kovner, Christine; Jones, Cheryl; Zhan, Chunliu; Gergen, Peter J.; Basu, Jayasree.

In: Health Services Research, Vol. 37, No. 3, 06.2002, p. 611-629.

Research output: Contribution to journalArticle

Kovner, Christine ; Jones, Cheryl ; Zhan, Chunliu ; Gergen, Peter J. ; Basu, Jayasree. / Nurse staffing and postsurgical adverse events : An analysis of administrative data from a sample of U.S. Hospitals, 1990-1996. In: Health Services Research. 2002 ; Vol. 37, No. 3. pp. 611-629.
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